Natality decline and spatial variation in excess death rates during the 1918–1920 influenza pandemic in Arizona, United States

Sushma Dahal, Kenji Mizumoto, Robert Bolin, Cécile Viboud, Gerardo Chowell

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

A large body of epidemiologic research has concentrated on the 1918 influenza pandemic, but more work is needed to understand spatial variation in pandemic mortality and its effects on natality. We collected and analyzed 35,151 death records from Arizona for 1915–1921 and 21,334 birth records from Maricopa county for 1915–1925. We estimated the number of excess deaths and births before, during, and after the pandemic period, and we found a significant decline in the number of births occurring 9–11 months after peak pandemic mortality. Moreover, excess mortality rates were highest in northern Arizona counties, where Native Americans were historically concentrated, suggesting a link between ethnic and/or sociodemographic factors and risk of pandemic-related death. The relationship between birth patterns and pandemic mortality risk should be further studied at different spatial scales and in different ethnic groups.

Original languageEnglish (US)
Pages (from-to)2577-2584
Number of pages8
JournalAmerican journal of epidemiology
Volume187
Issue number12
DOIs
StatePublished - 2018

Keywords

  • 1918–1920
  • Arizona
  • Birth
  • Excess mortality
  • Influenza pandemic
  • Maricopa county
  • Natality

ASJC Scopus subject areas

  • Epidemiology

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